GLP-1 receptor agonists may affect colonoscopy bowel prep
A retrospective cohort study found that patients taking glucagon-like peptide-1 (GLP-1) receptor agonists for diabetes or obesity had lower-quality bowel prep for colonoscopy and were more likely to be called back for a repeat test.
Patients taking glucagon-like peptide-1 (GLP-1) receptor agonists may be more likely to have inadequate bowel prep for colonoscopy as well as to need a repeat test, a recent study found.
Researchers performed a retrospective cohort study of patients who were taking GLP-1 receptor agonists for diabetes or obesity and had screening or surveillance colonoscopy at a large U.S. academic medical center between December 2021 and December 2022. Patients who had been prescribed GLP-1 receptor agonists before but not within three months of colonoscopy were included as controls, and patients who were taking promotility or antimotility drugs or who did not have a Boston Bowel Preparation Scale (BBPS) score on their procedure report were excluded. Quality of bowel prep was compared in the case and control groups. The study results were published Oct. 19 by the American Journal of Gastroenterology.
Four hundred forty-six patients were included in the study, 265 (59%) cases and 181 (41%) controls. A higher proportion of cases had diabetes at baseline, but there were no other statistically significant differences between the groups. Mean BBPS score was significantly higher in controls than in cases (7.5 ± 1.9 vs. 7.0 ± 2.4); this difference remained significant when the researchers controlled for diabetes (P=0.046). (BBPS scores range from 0 to 9, with 0 indicating an unprepared colon.) Cases were significantly more likely than controls to have a total BBPS score below 5 (15.5% vs. 6.6%; P=0.01) and to require a repeat colonoscopy due to poor bowel prep (18.9% vs. 11.1%; P=0.041).
The authors cautioned that their study was retrospective, involved a single health system, and included mostly non-Hispanic White patients and that they did not consider or control for diabetes complications. “The use of [GLP-1 receptor agonists] was associated with a statistically significantly lower quality of bowel preparation and was clinically significant given a notable difference in the need for a repeat colonoscopy,” they concluded. “It will be essential to understand the cumulative effect of medications that may delay gastric emptying on the quality of bowel preparation to better understand the appropriate measures and counseling that need to be taken before undergoing outpatient colonoscopies.”